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Women’s preconception health in England: a report card based on cross-sectional analysis of national maternity services data 2018/19: a report card based on cross-sectional analysis of national maternity services data from 2018/2019

Women’s preconception health in England: a report card based on cross-sectional analysis of national maternity services data 2018/19: a report card based on cross-sectional analysis of national maternity services data from 2018/2019
Women’s preconception health in England: a report card based on cross-sectional analysis of national maternity services data 2018/19: a report card based on cross-sectional analysis of national maternity services data from 2018/2019
Objective: to present the first national-level report card on the state of women’s preconception health in England.

Design: cross-sectional population-based study.

Setting: maternity services, England.

Population: all pregnant women in England with a first antenatal (booking) appointment recorded in the national Maternity Services Dataset (MSDS) from April 2018 to March 2019 (N=652,880).

Methods: we analysed the prevalence of 32 preconception indicator measures in the overall population and across sociodemographic subgroups. Ten of these indicators were prioritised for ongoing surveillance based on modifiability, prevalence, data quality and ranking by multidisciplinary UK experts.

Results: the three most prevalent indicators were: proportion of the 22.9% of women who smoked one year before pregnancy who did not quit smoking before pregnancy (85.0%), not taken folic acid supplementation before pregnancy (72.7%), and previous pregnancy loss (38.9%). Inequalities were observed by age, ethnicity and area-based deprivation level. The 10 indicators prioritised were: not taking folic acid supplementation before pregnancy, obesity, complex social factors, living in a most deprived area, smoking around the time of conception, overweight, pre-existing mental health condition, pre-existing physical health condition, previous pregnancy loss and previous obstetric complication.

Conclusions: our findings suggest important opportunities to improve the state of preconception health and reduce sociodemographic inequalities for women in England. In addition to MSDS data, other national data sources that record further and possibly better-quality indicators could be explored and linked to build a comprehensive surveillance infrastructure.
preconception health, routine health data, surveillance
1470-0328
1187-1195
Schoenaker, Danielle
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Stephenson, Judith
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Smith, Helen
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Thurland, Kate
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Duncan, Helen
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Godfrey, Keith
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Barker, Mary
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Singh, Claire
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Alwan, Nisreen
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Schoenaker, Danielle
84b96b87-4070-45a5-9777-5a1e4e45e818
Stephenson, Judith
b115169f-d010-4c24-8654-222613c3ed5c
Smith, Helen
d90cada4-0e14-4c80-8f34-7d01ca49fb17
Thurland, Kate
c588c7ae-28b7-49a9-a372-3598a1e4250c
Duncan, Helen
f9117d83-10bf-487c-b953-e3a8f21f7417
Godfrey, Keith
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Barker, Mary
374310ad-d308-44af-b6da-515bf5d2d6d2
Singh, Claire
2a95474f-ef83-4900-9e87-5b1bbbb32dc3
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382

Schoenaker, Danielle, Stephenson, Judith, Smith, Helen, Thurland, Kate, Duncan, Helen, Godfrey, Keith, Barker, Mary, Singh, Claire and Alwan, Nisreen (2023) Women’s preconception health in England: a report card based on cross-sectional analysis of national maternity services data 2018/19: a report card based on cross-sectional analysis of national maternity services data from 2018/2019. BJOG: An International Journal of Obstetrics & Gynaecology, 130 (10), 1187-1195. (doi:10.1111/1471-0528.17436).

Record type: Article

Abstract

Objective: to present the first national-level report card on the state of women’s preconception health in England.

Design: cross-sectional population-based study.

Setting: maternity services, England.

Population: all pregnant women in England with a first antenatal (booking) appointment recorded in the national Maternity Services Dataset (MSDS) from April 2018 to March 2019 (N=652,880).

Methods: we analysed the prevalence of 32 preconception indicator measures in the overall population and across sociodemographic subgroups. Ten of these indicators were prioritised for ongoing surveillance based on modifiability, prevalence, data quality and ranking by multidisciplinary UK experts.

Results: the three most prevalent indicators were: proportion of the 22.9% of women who smoked one year before pregnancy who did not quit smoking before pregnancy (85.0%), not taken folic acid supplementation before pregnancy (72.7%), and previous pregnancy loss (38.9%). Inequalities were observed by age, ethnicity and area-based deprivation level. The 10 indicators prioritised were: not taking folic acid supplementation before pregnancy, obesity, complex social factors, living in a most deprived area, smoking around the time of conception, overweight, pre-existing mental health condition, pre-existing physical health condition, previous pregnancy loss and previous obstetric complication.

Conclusions: our findings suggest important opportunities to improve the state of preconception health and reduce sociodemographic inequalities for women in England. In addition to MSDS data, other national data sources that record further and possibly better-quality indicators could be explored and linked to build a comprehensive surveillance infrastructure.

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Accepted/In Press date: 29 November 2022
e-pub ahead of print date: 21 February 2023
Published date: September 2023
Additional Information: Funding Information: The authors would like to thank members of the UK Preconception Partnership for their contribution to the ranking of preconception indicators to identify an initial set of priority indicators for national surveillance of preconception health using maternity services data. The UK Preconception Partnership (https://www.ukpreconceptionpartnership.co.uk/) is a coalition of groups representing different aspects of preconception health in women and their partners, including the Royal College of General Practitioners, the Royal College of Obstetricians and Gynaecologists, the Faculty of Sexual and Reproductive Healthcare, Department of Health and Social Care Office for Health Improvement and Disparities, Tommy's Charity, and academics in reproductive and sexual health, obstetrics and gynaecology, population health and epidemiology, nutritional sciences, behavioural sciences, and education in schools. Funding Information: DAJMS is supported by the National Institute for Health and Social Care Research (NIHR), Southampton Biomedical Research Centre [IS‐BRC‐1215‐20004]. KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the NIHR (NIHR Senior Investigator [NF‐SI‐0515‐10042] and NIHR Southampton Biomedical Research Centre [IS‐BRC‐1215‐20004]), the European Union (Erasmus+ Programme ImpENSA 598488‐EPP‐1‐2018‐1‐DE‐EPPKA2‐CBHE‐JP) and the British Heart Foundation (RG/15/17/3174). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. For the purpose of Open Access, the authors have applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission. Publisher Copyright: © 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
Keywords: preconception health, routine health data, surveillance

Identifiers

Local EPrints ID: 473223
URI: http://eprints.soton.ac.uk/id/eprint/473223
ISSN: 1470-0328
PURE UUID: b0f4c602-777a-42ae-98c6-cd871c86c5f7
ORCID for Danielle Schoenaker: ORCID iD orcid.org/0000-0002-7652-990X
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618
ORCID for Mary Barker: ORCID iD orcid.org/0000-0003-2976-0217
ORCID for Nisreen Alwan: ORCID iD orcid.org/0000-0002-4134-8463

Catalogue record

Date deposited: 12 Jan 2023 18:05
Last modified: 27 Feb 2024 03:07

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Contributors

Author: Judith Stephenson
Author: Helen Smith
Author: Kate Thurland
Author: Helen Duncan
Author: Keith Godfrey ORCID iD
Author: Mary Barker ORCID iD
Author: Claire Singh
Author: Nisreen Alwan ORCID iD

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